Cissy B. Kartasasmita
Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Padjadjaran Rumah Sakit Dr. Hasan Sadikin Bandung

Published : 18 Documents
Articles

Found 18 Documents
Search

The Association Between Initial Solid Food and Atopy in Children with or without Family History of Atopic Disease

Majalah Kedokteran Bandung Vol 1, No 42 (2010)
Publisher : Majalah Kedokteran Bandung

Show Abstract | Original Source | Check in Google Scholar

Abstract

Atopic diseases are the most common chronic diseases in childhood. Their incidence has a tendency to increase recently. The tendency of atopy could be triggered by many factors originated in the early life, including early introduction of solid food. To investigate the association between initial solid food and atopy, an analytic comparative study with historical cohort design was conducted from May to June 2006 in Pediatric Department of Hasan Sadikin Hospital Bandung. It was the second phase study of ´allergic prevalence and risk factors identificationin the first two years of life´. Out of 800 children in Garuda, Padasuka, and Babakansari Primary Health Care Center who were included in the first phase of the study, 749 children were eligible to continue the second phase of the study, 284 children were randomized into two groups of children with and without family history of atopic disease consisting of 142 children each. They then underwent skin prick test. History of initiation time of solid food were obtained from their parents. To analyze the data chi-square and odds ratio with 95% confidence interval were used. Among 284 children who fullfilled the inclusion criteria, 50% had family history of atopic disease. Atopy was found in 28.2% children, 32.4% with family history of atopic disease and 23.9% without family history of atopic disease. There was no significant correlation between family history of atopic disease and atopy (p=0.113). There was a high risk for atopy related to initial solid food (OR = 4.50, 95%CI = 1.96-10.74, p < 0.001). The difference of atopy was strongly significant between children who had initial solid food at the age of <6 months and at the age of >6 months whether or not the children had family history of atopic disease (p=0.016 and p=0.002). Conclusions: A significant increase in the risk of childhood atopy occured if initial solid food is given at the age of <6 months, whether or not the children have family history of atopic disease.Hubungan antara Waktu Pemberian Makanan Pendamping ASIdan Kejadian Atopi pada Anak dengan atau Tanpa Riwayat PenyakitAtopik dalam KeluargaPenyakit atopik merupakan penyakit kronik yang paling sering ditemukan pada anak. Angka kejadian penyakit atopik cenderung meningkat dari tahun ke tahun. Kecenderungan atopi atau timbulnya penyakit atopik dapat dicetuskan oleh faktor faktor yang berpengaruh di awal kehidupan, salah satunya adalah pemberian makanan pendamping ASI (MP ASI). Untuk mengetahui hubungan antara waktu pemberian MP ASI dan kejadian atopi dilakukan penelitian analitik komparatif dengan rancangan historical cohort. Penelitian dilakukan pada bulan Mei-Juni 2006 di Bagian Ilmu Kesehatan Anak Rumah Sakit Hasan Sadikin Bandung. Penelitian ini merupakan fase kedua dari penelitian “Prevalens alergi dan identifikasi faktor risiko pada dua tahun pertama kehidupan”. Penelitian dilakukan di Puskesmas Garuda, Padasuka, dan Babakansari. Dari 800 anak yang mengikuti fase I, sebanyak 749anak dapat diteliti pada penelitian fase II. Dengan teknik sampling secara acak terpilih 142 anak, masing-masing dari  kelompok dengan dan tanpa riwayat penyakit atopik dalam keluarga. Selanjutnya dilakukan pemeriksaan uji tusuk kulit dan ditanyakan mengenai riwayat pemberian MP ASI. Analisis statistik yang digunakan adalah uji kai-kuadrat dan Odds ratio dengan IK95%. Dua ratus delapan puluh empat anak memenuhi kriteria inklusi penelitian. Dari jumlah tersebut diperoleh 50% anak dengan riwayat penyakit atopik dalam keluarga. Atopi didapatkan pada 28,2% anak, 32,4% di antaranya dengan riwayat penyakit atopik dan 23,9% tanpa riwayat penyakit atopik dalam keluarga. Tidak terdapat hubungan yang bermakna antara anak dengan riwayat penyakit atopik dalam keluarga dan kejadian atopi (p=0,113). Dua ratus delapan (73,2%) anak mendapat MP ASI pada usia <6 bulan, 76 (26,8%) anak mendapat ASI pada usia >6 bulan. Kejadian atopi berbeda bermakna antara anak yang mendapat MP ASI pada usia <6 bulan dan >6 bulan (OR=4,50; IK95%=1,96-10,47; p<0,001), baik pada kelompok anak dengan riwayat penyakit atopik (OR=3,38; IK95%=1,12-10,86; p=0,016) maupun tanpa riwayat penyakit atopik (OR=6,08; IK95%=1,63-26,72, p=0,002) dalam keluarga. Kesimpulan: Pemberian MP ASI pada usia <6 bulan meningkatkan risiko terjadinya atopi, baik pada kelompok anak dengan atau tanpa riwayat penyakit atopik dalam keluarga.

Polimorfisme FokI, BsmI, ApaI, dan TaqI Gen Reseptor Vitamin D pada Kejadian Tuberkulosis Anak

Majalah Kedokteran Bandung Vol 42, No 4 (2010)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Original Source | Check in Google Scholar

Abstract

Tuberkulosis (TB) adalah penyakit infeksi yang disebabkan oleh Mycobacterium tuberculosis. Faktor kuman saja tidak dapat menjadi faktor tunggal dalam kejadian TB. Varian polimorfisme gen reseptor vitamin D (RVD) dianggap penting hubungannya dengan kerentanan dan resistensi terhadap TB. Penelitian ini bertujuan untuk mengetahui peran polimorfisme FokI, BsmI, ApaI, dan TaqI gen RVD terhadap kejadian TB anak. Penelitian observasional analitik dengan rancangan kasus kontrol ini dilakukan di Bagian Ilmu Kesehatan Anak RSUP Dr. Hasan Sadikin Bandung dan Rumah Sakit Umum Cibabat Cimahi sejak Mei 2008–Maret 2009. Sampel terdiri dari 42 anak TB (kelompok kasus) dan 42 anak non-TB (kelompok kontrol) yang memenuhi kriteria penelitian dan diambil secara consecutive sampling. Dilakukan pemeriksaan polimorfisme FokI, BsmI, ApaI, dan TaqI gen RVD. Analisis dengan uji Chi-kuadrat, uji Mann-Whitney, menghitung rasio Odds (OR) dan 95% CI. Kejadian polimorfisme FokI gen RVD pada kelompok kasus TB 66,7% dan kontrol 40,5% (p=0,016) dengan OR (95% CI): 2,94 (1,21–7,16). Kejadian polimorfisme FokI gen RVD untuk kelompok kasus TB adalah 2,94 kali lebih banyak dibandingkan dengan kontrol. Polimorfisme BsmI, ApaI, dan TaqI gen RVD tidak terdapat perbedaan bermakna antara kelompok kasus TB dibandingkan dengan kontrol (p >0,05). Disimpulkan bahwa polimorfisme FokI gen RVD merupakan faktor risiko terjadinya TB anak. [MKB. 2010;42(4):187–94].Kata kunci: Gen reseptor vitamin D, polimorfisme, tuberkulosis anakPolymorphism of FokI, BsmI, ApaI, and TaqI Vitamin D Receptor Gene on Child TuberculosisTuberculosis (TB) is a infection disease caused by Mycobacterium tuberculosis. Mycobacterium tuberculosis itself is not the only factor of TB. Polymorphism of vitamin D receptor (VDR) gene is important on the susceptibility of TB. The aim was to find out the role of FokI, BsmI, ApaI, and TaqI VDR gene polymorphism on child TB. The observational analytic study with case control design was done in RSUP Dr. Hasan Sadikin Bandung and RSU Cibabat Cimahi, May 2008–March 2009. The subjects consisted of 42 children each for case (TB) and control (non TB) group, enrolled by consecutive sampling. The blood was analyzed for polymorphism of FokI, BsmI, ApaI, and TaqI VDR gene. Chi-square test, Mann-Whitney test, to calculate odds ratio (OR) and 95% confidence interval (CI) were used. The incidence of FokI VDR gene polymorphism in TB case group was 66.7% and 40.5% in control group (p=0.016), OR (95% CI): 2.94 (1.21–7.16). The FokI VDR gene polymorphism for TB group was 2.94 times greater than that for control group; while for BsmI, ApaI, and TaqI VDR gene polymorphism, there was no significant difference between TB case and control (p>0.05). It is concluded, FokI VDR gene polymorphism is a risk factor of child TB. [MKB. 2010;42(4):187–94].Key words: Child tuberculosis, polymorphism, vitamin D receptor gene DOI: http://dx.doi.org/10.15395/mkb.v42n4.35

Kadar Laktat Darah sebagai Faktor Risiko Mortalitas pada Sepsis Neonatorum

Majalah Kedokteran Bandung Vol 45, No 4 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Original Source | Check in Google Scholar

Abstract

Tolak ukur dini, bedside, dan parameter dapat tersedia di semua fasilitas kesehatan masih diperlukan untuk memantau perubahan metabolisme dan memperkirakan mortalitas pada sepsis neonatorum. Penelitian ini bertujuan mengetahui laktat darah sebagai faktor risiko mortalitas pada sepsis neonatorum. Penelitian berupa kohort prospektif dan dilakukan di RS Dr. Hasan Sadikin Bandung periode September–November 2010 dengan subjek adalah sepsis neonatorum. Pemeriksaan laktat darah menggunakan alat accutrend® lactate Plus yang dilakukan pada awal diagnosis, 12 jam, 24 jam, dan 48 jam pertama perawatan; kemudian dilakukan follow-up sampai penderita meninggal, pulang, atau hidup sampai usia 28 hari pascadiagnosis sepsis neonatorum. Data karakteristik subjek, gejala-gejala klinis, dan hasil pemeriksaan laboratorium dianalisis dengan univariat. Hasil analisis p<0,25 dianalisis dengan regresi logistik. Nilai yang bermakna bersama dengan kadar laktat darah 12 jam dianalisis dengan cox proportional hazard model. Setelah dilakukan observasi terdapat 28 neonatus mengalami kematian dari 69 neonatus yang didiagnosis sepsis neonatorum. Berat badan lahir <2.500 gram (p=0,008), usia kehamilan <37 minggu (p=0,006), retraksi (p=0,010), dan waktu pengisian kapiler ≥3 detik (p=0,042) berhubungan dengan mortalitas. Hiperlaktatemia pada 12 jam meningkatkan risiko mortalitas tiga kali pada sepsis neonatorum (HR 3,062; IK 95%: 1,078–8,700). Kesimpulan penelitian ini adalah hiperlaktatemia 12 jam merupakan faktor risiko mortalitas pada sepsis neonatorum. [MKB. 2013;45(4):199–205]Kata kunci: Faktor risiko, laktat, mortalitas, neonatal, sepsis Blood Lactate Level as Mortality Risk Factor in Neonatal SepsisEarly, bedside, and readily available parameters to observe metabolic changes and predicted mortality in neonatal sepsis is still needed in every health facility. The aim of this study was to explore blood lactate as apossible mortality risk factor in neonatal sepsis. A prospective cohort study was held during the period of September–November 2010 involving newborns diagnosed as suffering from neonatal sepsis in Dr. Hasan Sadikin General Hospital Bandung. Blood lactate was measured with accutrend® lactate Plus at admission and in 2, 24 and 48 hours of hospitalization. We performed univariate analysis on subject characteristics, clinical symptoms, and laboratory examination data. Results with p<0.25 were re-analyzed using logistic regression. Significant results along with the 12 hour blood lactate level were analyzed using cox proportional hazard model. Based on the observation, of the 69 newborns included in this study, 28 died. Statistic analysis showed significant correlation between mortality and birth weight <2,500 gram (p=0.008), gestational age <37 weeks (p=0.006), retraction (p=0.010), and capillary refill time ≥3 seconds (p=0.042). Hyperlactatemia in 12 hours increased the risk for mortality in neonatal sepsis (HR 3.062, CI 95%:1.078–8.700). It is concluded that hyperlactatemia in 12 hours is the risk factor for mortality in neonatal sepsis. [MKB. 2013;45(4):199–205]Key words: Blood lactate, mortality, neonatal, risk factor, sepsis DOI: http://dx.doi.org/10.15395/mkb.v45n4.165

Nasopharyngeal bacterial carriage and antimicrobial resistance in underfive children with community acquired pneumonia

Medical Journal of Indonesia Vol 11, No 3 (2002): July-September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Original Source | Check in Google Scholar | Full PDF (227.086 KB)

Abstract

Pathogens in nasopharynx is a significant risk factor of pneumonia. According to WHO, isolates to be tested for antimicrobial resistance in the community should be obtained from nasopharyngeal (NP) swabs. The aim of this study is to know the bacterial patterns of the nasopharynx and cotrimoxazole resistance in under five-year old children with community acquired pneumonia. The study was carried out in 4 primary health clinic (Puskesmas) in Majalaya sub-district, Bandung, West Java, Indonesia. All underfive children with cough and/or difficult breathing and classified as having non-severe pneumonia (WHO guidelines) were placed in Amies transport medium and stored in a sterile jar, before taken to the laboratory for further examination, in the same day. During this nine month study, 698 children with clinical signs of non-severe pneumonia were enrolled. About 25.4% (177/698) of the nasopharyngeal specimens yielded bacterial isolates; i.e. 120 (67.8%) were positive for S pneumoniae, 21 for S epidermidis and alpha streptococcus, 6 for Hafnia alvei, 5 for S aureus, 2 for B catarrhalis, and 1(0.6%) for H influenza and Klebsiella, respectively. The antimicrobial resistance test to cotrimoxazole showed that 48.2% of S pneumoniae strain had full resistance and 32.7% showed intermediate resistance to cotrimoxazole. This result is almost similar to the other studies from Asian countries. It seems that H influenza is not a problem in the study area, however, a further study is needed. (Med J Indones 2002; 11: 164-8) Keywords: nasopharyngeal swab, S pneumoniae, cotrimoxazole

Kematian Akibat Pneumonia Berat pada Anak Balita

Majalah Kedokteran Bandung Vol 45, No 1 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Original Source | Check in Google Scholar

Abstract

Pneumonia merupakan penyebab utama kesakitan dan kematian pada anak, terutama di negara berkembang. Angka kematian karena pneumonia di negara berkembang 10–15 kali lebih tinggi daripada di negara maju. Penelitian ini bertujuan untuk mengetahui angka kematian dan faktor risiko pada anak balita yang dirawat di rumah sakit karena pneumonia. Penelitian potong lintang ini dilakukan pada anak usia 1–59 bulan yang dirawat di Rumah Sakit Dr. Hasan Sadikin Bandung karena pneumonia periode November 2007─Januari 2009. Tiga ratus delapan belas anak ikut serta dalam penelitian ini. Usia median anak 11‚6 bulan, sebanyak 237 (74‚5%) di antaranya berusia ≤12 bulan. Sembilan puluh tiga (29‚2%) anak didiagnosis pneumonia sangat berat dan 225 (70‚8%) anak pneumonia berat. Dua puluh tiga (7‚2%) penderita meninggal selama perawatan, 20 di antaranya dirawat dengan pneumonia sangat berat (p<0,001; OR 20,274; 95%IK: 5,855–70,197). Kelainan jantung bawaan (p=0,002; OR 5,795; 95%IK: 2,115–15,407) dan leukositosis (≥15.500/mm3; p=0,002; OR 3,879; 95%IK: 1,547–9,727) berhubungan erat dengan kematian. Kuman patogen ditemukan pada 11 dari 23 penderita yang meninggal. Simpulan, kematian karena pneumonia berat masih cukup tinggi. Pneumonia sangat berat, kelainan jantung bawaan, dan leukositosis merupakan faktor risiko yang meningkatkan kematian anak balita dengan pneumonia. [MKB. 2013;45(1):50–5]Mortality Due to Severe Pneumonia in Under-Five Years Old ChildrenPneumonia is one of the leading causes of morbidity and mortality in children, mainly in developing countries with a 10–15 times higher mortality rate than developed countries. The aim of the study was to know the mortality rate and its risk factors among under five years old children who were hospitalized due to severe pneumonia. This cross-sectional study was conducted to 1 to 59 months old children with pneumonia at the Department of Pediatric Dr. Hasan Sadikin Bandung Hospital from November 2007 to January 2009. Three hundred and eighteen children were enrolled in this study. The median age was 11.16 months, and 237 (74.5%) were ≤12 months of age. Very severe pneumonia was diagnosed in 93 (29.2%) and severe pneumonia in 225 (70.8%) children. Twenty three (7.2%) children died during hospitalization, 20 were hospitalized with very severe pneumonia (p<0.001, OR 20.274, 95%CI: 5.855─70.197). Congenital heart disease (p=0.002, OR 5.795, 95%CI: 2.115–15.407) and leucocytosis (≥15,500/mm3, p=0.002, OR 3.879, 95%CI: 1.547–9.727) were significantly associated to the mortality. Pathogenic bacteria were identified in 11 of 23 patients. In conclusions, the mortality of severe pneumonia is still high. Very severe pneumonia, congenital heart disease and leucocytosis are factors that increase mortality among under-five years old children with pneumonia. [MKB. 2013;45(1):50–5] DOI: http://dx.doi.org/10.15395/mkb.v45n1.140

Epidemiologi Tuberkulosis

Sari Pediatri Vol 11, No 2 (2009)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Original Source | Check in Google Scholar

Abstract

Tuberkulosis (TB) masih merupakan penyebab utama morbiditas dan mortalitas pada anak di dunia, namunkurang mendapat prioritas dalam penanggulangannya. Data surveilans dan epidemiologi TB pada anak jarangdidapat. Hal ini disebabkan berbagai faktor antara lain sulitnya diagnosis TB anak, meningkatnya TB ekstraparu pada anak, tidak adanya standar baku definisi kasus, dan prioritas yang kurang diberikan pada TB anakdi banding TB dewasa. Berbagai penelitian menunjukkan prevalensi TB anak tinggi, namun umumnya tanpakonfirmasi pemeriksaan bakteri tahan asam (BTA) positif. Salah satu indikator untuk menilai situasi TB dikomunitas adalah dengan Annual Risk of Tuberculosis Infection (ARTI), adalah indeks epidemiologi yangdipakai untuk evaluasi dan monitor keadaan tuberkulosis di suatu komunitas atau negara. Perbedaan angkamorbiditas dan mortalitas TB di berbagai negara dipengaruhi oleh beberapa faktor risiko, dibedakan antararisiko infeksi TB dan sakit TB.

Hubungan Kadar Feritin Serum dengan Gangguan Fungsi Paru Pasien Thalassemia Mayor Anak

Sari Pediatri Vol 16, No 3 (2014)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Original Source | Check in Google Scholar

Abstract

Latar belakang. Gangguan fungsi paru merupakan komplikasi thalassemia yang sering dilupakan. Kelebihan besi yang ditandai peningkatan kadar feritin serum diduga merupakan penyebab terjadinya gangguan fungsi paru pada pasien thalassemia mayor.Tujuan. Menganalisis hubungan kadar feritin serum dengan gangguan fungsi paru pasien thalassemia mayor anak serta menentukan batasan kadar feritin serum yang berhubungan dengan gangguan fungsi paru.Metode. Penelitian cross-sectional dilaksanakan pada bulan April-Mei 2013. Dilibatkan 45 anak thalassemia mayor di Poliklinik Thalassemia RS Dr. Hasan Sadikin, Bandung. Setiap subjek dilakukan anamnesis, pemeriksaan fisis, kadar feritin serum, dan spirometri. Analisis hubungan kadar feritin serum dengan gangguan fungsi paru digunakan uji regresi logistik dengan pertimbangan variabel perancu serta kurva ROC untuk menentukan batasan kadar feritin serum yang berhubungan dengan gangguan fungsi paru.Hasil. Sejumlah 45 anak memenuhi kriteria penelitian. Di antara 45 anak, 16 mengalami gangguan fungsi paru restriktif dengan derajat gangguan bervariasi, 11 anak gangguan ringan, 4 sedang, 1 berat, dan tidak ada yang mengalami gangguan fungsi paru obstruktif atau campuran. Rerata kadar feritin serum � � kelompok gangguan fungsi paru restriktif (7.151,88 μg/L) lebih tinggi dibandingkan kelompok paru normal (3.450,34 μg/L) dan kadar feritin 4.839 μg/L berhubungan dengan gangguan fungsi paru. Pada pasien thalassemia mayor anak didapatkan korelasi kadar feritin serum dengan gangguan fungsi paru (p=0,000, OR=50,754).Kesimpulan. Terdapat hubungan bermakna kadar feritin serum dengan gangguan fungsi paru pasien thalassemia mayor anak dan kadar feritin 4.839 μg/L merupakan batasan kadar feritin yang berhubungan dengan gangguan fungsi paru.

Nasopharyngeal bacterial carriage and antimicrobial resistance in underfive children with community acquired pneumonia

Paediatrica Indonesiana Vol 41, No 6 (2001): November 2001
Publisher : Indonesian Pediatric Society

Show Abstract | Original Source | Check in Google Scholar

Abstract

Lung puncture is the best way to determine the etiology of pneumonia since it yields the highest rate of positive cultures. However, this procedure is difficult, especially for a study in the community. According to WHO, isolates to be tested for antimicrobial resistance in the community should be obtained from nasopharyngeal (NP) swabs. Previous studies support the use of NP isolates to determine antimicrobial resistance patterns of isolates from children with pneumonia. The aim of our study was to know the bacterial patterns of the nasopharynx in underfive children with community acquired pneumonia and their antimicrobial resistance. The study was carried out in 4 Primary Health Clinics in Majalaya sub-district, Bandung, Indonesia. All underfives with cough or difficult breathing and classified as having non-severe pneumonia (WHO guidelines), were included in the study. Nasopharyngeal swabs (CDC/WHO Manual) were obtained by the doctor, the swabs were placed in Amies transport medium and stored in a sterile jar before taken to the laboratory in the same day. All children were treated with co-trimoxazole. During the nine month study, 698 children with clinical signs of non-severe pneumonia were enrolled. About 25% of the nasopharyngeal specimens yielded bacterial isolates; the two most frequently found were S. pneumoniae and S. epidermidis. The antimicrobial resistance test to co-trimoxazole showed 48.2% S. pneumoniae strain had full resistance and 32.7% showed intermediate resistance to co-trimoxazole. This result is almost similar to other studies from Asian countries. It seems that H. influenzae is not a problem in the study area; however, further studies are needed.

Risk Factors for Acute Respiratory Infections in Underfive Children

Paediatrica Indonesiana Vol 35 No 3-4 (1995): March 1995
Publisher : Indonesian Pediatric Society

Show Abstract | Original Source | Check in Google Scholar | Full PDF (967.499 KB)

Abstract

A longitudinal study on acute inspiratory infections was conducted from April 1988 until June 1990, in Cikutra, an urban community in the municipality of Bandung, Indonesia. The study consisted of. 3 parts: a presurvey, a cross sectional study, and a one-year prospective study. All children aged less than five years in Cikutra were included in the presurvey. A simple questionnaire was used for collecting data. In the cross sectional study 500 children were selected by stratified random sampling. Field investigators visited the children's homes and interviewed mothers using a standardized questionnaire. For the prospective study 269 children of less than 48 months of age were enrolled, and followed for one year. The prevalence of all ARI was 57-58%, mild-moderate ARl 55-56% , and severe ARJ 5%. On average the children suffered from 6.7 episodes of ARl per child per year, with a mean duration of episode of 5.3 days. Several factors showed significant relationship with the prevalence, incidence, severity of duration of ARI.

Jadwal Imunisasi Anak Usia 0 – 18 tahun Rekomendasi Ikatan Dokter Anak Indonesia 2017

Sari Pediatri Vol 18, No 5 (2017)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Original Source | Check in Google Scholar

Abstract

Ikatan Dokter Anak Indonesia melalui Satuan Tugas Imunisasi mengeluarkan rekomendasi Imunisasi IDAI tahun 2017 untuk menggantikan jadwal imunisasi sebelumnya. Jadwal imunisasi 2017 ini bertujuan menyeragamkan jadwal imunisasi rekomendasi IDAI dengan jadwal imunisasi Kementerian Kesehatan RI khususnya untuk imunisasi rutin. Jadwal imunisasi 2017 juga dibuat berdasarkan ketersediaan kombinasi vaksin DTP dengan hepatitis B seperti DTPw-HB-Hib, DTPa-HB-Hib-IPV, dan dalam situasi keterbatasan atau kelangkaan vaksin tertentu seperti vaksin DTPa atau DTPw tanpa kombinasi dengan vaksin lainnya. Hal baru yang terdapat pada jadwal 2017 antara lain: vaksin hepatitis B monovalen tidak perlu diberikan pada usia 1 bulan apabila anak akan mendapat vaksin DTP-Hib kombinasi dengan hepatitis B; bayi paling sedikit harus mendapat satu dosis vaksin IPV (inactivated polio vaccine) bersamaan (simultan) dengan OPV-3 saat pemberian DTP-3; vaksin DTPw direkomendasikan untuk diberikan pada usia 2,3 dan 4 bulan. Hal baru yang lain adalah untuk vaksin influenza dapat diberikan vaksin inaktif trivalen atau quadrivalen, vaksin MMR dapat diberikan pada usia 12 bulan apabila anak belum mendapat vaksin campak pada usia 9 bulan. Vaksin HPV apabila diberikan pada remaja usia 10-13 tahun, pemberian cukup 2 dosis dengan interval 6-12 bulan; respons antibodi setara dengan 3 dosis. Vaksin Japanese Encephalitis direkomendasikan untuk diberikan mulai usia 12 bulan pada daerah endemis atau pada turis yang akan bepergian ke daerah endemis. Vaksin dengue direkomendasikan untuk diberikan pada anak usia 9-16 tahun dengan jadwal 0, 6, dan 12 bulan. Dengan pemberian imunisasi sesuai rekomendasi, diharapkan anak-anak Indonesia terlindungi dari penyakit infeksi yang dapat dicegah dengan imunisasi.